Nerve Repositioning

The inferior alveolar nerve, which gives feeling to the lower lip and chin, may need to be moved in order to make room for the placement of dental implants in the lower jaw. A nerve repositioning procedure is limited to the lower jaw and may be indicated when teeth are missing in the area of the two back molars and/or second premolars. This procedure is considered a very aggressive approach since there is almost always some postoperative numbness of the lower lip and jaw area, which typically dissipates very slowly, but may be permanent. Usually other, less aggressive options are considered first (placement of blade implants, etc).

Typically, we remove an outer section of the cheek on the side of the lower jaw bone in order to expose the nerve and vessel canal. We then isolate the nerve and vessel bundle in that area and slightly pull it out to the side. We then place the implants while tracking the neuro-vascular bundle. Then the bundle is released and placed back over the implants. The surgical access is refilled with bone graft material of the surgeon’s choice and the area is closed.

These procedures may be performed separately or together depending upon the individual’s condition. As stated earlier, there are several areas of the body that are suitable for attaining bone grafts. In the maxillofacial region bone grafts can be taken from inside the mouth, in the area of the chin or third molar region, or in the upper jaw behind the last tooth. In more extensive situations a greater quantity of bone can be attained from the hip or the outer aspect of the tibia at the knee. When we use the patient’s own bone for repairs or additions, we generally get the best results.

In many cases, we can use allograft material to implement bone grafting for dental implants. This bone is prepared from cadavers and is used to get the patient’s own bone to grow into the repair site. It is quite effective and very safe. Synthetic materials can also be used to stimulate bone formation. We even use factors from your own blood to accelerate and promote bone formation in graft areas.

These surgeries are performed in the out-office surgical suite under IV sedation or general anesthesia. After discharge, bed rest is recommended for one day, as well as limited physical activity for one week.

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See what our patients are saying

"Josh's experience with having his teeth out at ROMS was awesome. Your entire staff was friendly, smiling and professional. Our nurse was so kind and caring and checked on Josh frequently and helped me walk him to the vehicle afterwards. I felt as if Josh was in great hands and care the entire time we were there. The fact that you called the night of the extraction was very nice. Thank you for calling afterwards.
Josh has had zero complications, the healing went just as you indicated it would, by Monday that he would be turning the corner.
Also, including the medications in his bag of supplies was very helpful and appreciated.
Thank you for taking care of my son in a most professional caring manner."Jackie W.

"My name is Jayme. I recently had two surgical procedures done by Dr. Matthew Bruksch. I am so grateful to have him as oral surgeon. His staff and team treat you like family when you walk into their office and will do whatever it takes to help you; Whether it be, with your insurance company or your procedure. I highly recommend Dr. Matthew Bruksch and staff to anyone! Thank you so much for what you have done for me."Jayme S.

"Thank you very much. Overall it was a pleasant experience. I was very nervous coming in to have the procedure done. The nurse and the doctor were very reassuring and did a good job of calming me down. The procedure itself went great. The Dr did an amazing job and I had no pain during it. Overall I rate my experience a 10. Thank you guys very much and I would definitely refer other people to OMS. Ladies at the front desk were also very good and helpful. Everyone was very knowledgeable about everything. Again thank you."Nathan D.